| Agent | Dose | Days | Cycle_Length | Notes |
|---|---|---|---|---|
| Azacitidine | 35 mg/m² | Days 1-7 | Every 28 days | |
| Decitabine | 5 mg/m² | Days 1-5 | Every 28 days | ±G-CSF |
| Decitabine-Cedazuridine (Inqovi) | 35/100 mg | Days 1-3 | Every 28-42 days | Alternative if IV administration not feasible |
14 Post-Transplant Maintenance Therapy Visualization
14.1 Introduction
This document provides visualizations of the recommended maintenance therapy strategies for myeloid malignancies following allogeneic hematopoietic stem cell transplantation (HSCT) as outlined in the Standard Practice Guidelines (SPG R v. 1.00).
14.2 1. Maintenance Therapy Decision Algorithm
Maintenance Therapy Decision Algorithm
| Initial Assessment | Criteria | Recommendation |
|---|---|---|
| Patient with myeloid malignancy post-HSCT | Prior clinical trial | Refer to trial protocol for maintenance |
| FLT3-ITD mutation (MRD positive) | Gilteritinib maintenance Start Day +30 to +90 Continue for 2 years Alternative: Consider quizartinib if remission achieved on it prior to HSCT |
|
| FLT3-TKD mutation | Not recommended Consider midostaurin if remission achieved on it prior to HSCT |
14.3 2. HMA Maintenance Therapy Regimens
14.4 3. Timing of Maintenance Therapy
14.5 4. Monitoring Requirements
Monitoring Requirements Based on Mutation Status
| Mutation | NGS | PCR MRD | Monitoring Schedule | Additional Notes |
|---|---|---|---|---|
| FLT3-ITD | Yes | Yes (Invivoscribe) | Pre-HSCT, Day +30, Day +90 | Email C.mosse@vumc.org before ordering |
| NPM1 | Yes | Yes (ARUP RT-PCR) | Pre-HSCT, Day +30, Day +90 | ARUP RT-PCR preferred over Invivoscribe |
14.6 Conclusion
This document provides a subset of visualizations for the Standard Practice Guidelines (SPG) on Post-Transplant Maintenance Therapy for myeloid malignancies. The complete document contains additional visualizations not shown in this minimal version.